title: Malignant peritoneal mesothelioma treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: is GLUT1 expression a major prognostic factor? A preliminary study.
abstract: OBJECTIVE
  Diffuse malignant peritoneal mesothelioma (DMPM) is a rare primary peritoneal malignancy. Its prognosis has been improved by an aggressive locoregional treatment combining extensive cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Prognostic factors are currently poorly defined for this disease but are essential if treatment is to be standardized.
  
  
  METHODS
  Twenty-eight patients with DMPM, who were considered preoperatively to be candidates for CRS and HIPEC between June 1998 and August 2010 at our institution, were selected for this study. Medical records and histopathological features were retrospectively reviewed and 24 clinical, histological, and immunohistochemical parameters were assessed for their association with overall survival by univariate and multivariate analyses.
  
  
  RESULTS
  The following factors were significantly associated with overall survival by univariate analysis: predominant histological growth pattern in the epithelioid areas, nuclear grooves in the epithelioid areas, atypical mitoses, and calretinin and GLUT1 expression by immunohistochemistry in the epithelioid areas. Expression of the facilitative glucose transporter protein GLUT1 in the epithelioid areas was the only factor independently associated with overall survival by multivariate analysis.
  
  
  CONCLUSIONS
  GLUT1 expression appears to be an indicator of poor prognosis in DMPM. Standard histological classification of DMPM may not be adequate to select patients for aggressive locoregional treatments, such as CRS and HIPEC. Multicenter validation of the prognostic factors identified in this preliminary study is needed to refine patient selection for potential cure.
authors.affiliation: Service de Chirurgie Générale, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France.
authors.forename: J
authors.initials: J
authors.lastname: Hommell-Fontaine
authors.forename: S
authors.initials: S
authors.lastname: Isaac
authors.forename: G
authors.initials: G
authors.lastname: Passot
authors.forename: E
authors.initials: E
authors.lastname: Decullier
authors.forename: A
authors.initials: A
authors.lastname: Traverse-Glehen
authors.forename: E
authors.initials: E
authors.lastname: Cotte
authors.forename: B
authors.initials: B
authors.lastname: You
authors.forename: F
authors.initials: F
authors.lastname: Mohamed
authors.forename: F N
authors.initials: FN
authors.lastname: Gilly
authors.forename: O
authors.initials: O
authors.lastname: Glehen
authors.forename: F
authors.initials: F
authors.lastname: Berger
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D010478:Chemotherapy, Cancer, Regional Perfusion; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D051272:Glucose Transporter Type 1 / Q000378:metabolism*; D006801:Humans; D006979:Hyperthermia, Induced; D007124:Immunoenzyme Techniques; D008175:Lung Neoplasms / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D008297:Male; D008654:Mesothelioma / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D046888:Tissue Array Analysis
chemical_list: D014408:Biomarkers, Tumor; D051272:Glucose Transporter Type 1; C495677:SLC2A1 protein, human